Provider Demographics
NPI:1851903504
Name:ACOSTA-VALDES, YESENIA CLARA (PHARMD)
Entity Type:Individual
Prefix:
First Name:YESENIA
Middle Name:CLARA
Last Name:ACOSTA-VALDES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:YESENIA
Other - Middle Name:CLARA
Other - Last Name:CASTELLANOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:9895 SW 58TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-1414
Mailing Address - Country:US
Mailing Address - Phone:305-766-7783
Mailing Address - Fax:
Practice Address - Street 1:15195 SW 42ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-3949
Practice Address - Country:US
Practice Address - Phone:305-223-7895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-22
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS59928183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist